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Do I Have Psoriasis? Understanding Psoriasis Symptoms

How to Identify, Treat, and Manage This Autoimmune Skin Disease

Do you have persistent itchy, red, burning or stinging skin that won’t go away on its own? Psoriasis is an autoimmune skin disease that affects nearly 8 million Americans, and 125 million individuals worldwide. However, it is important to understand psoriasis symptoms, and work with your dermatologist to find a treatment option that works for you.

First, let’s discuss what psoriasis is. Psoriasis is a chronic, autoimmune skin disease that can affect any part of the body, but is often found on the knees, elbows, or scalp. According to the National Psoriasis Foundation, psoriasis is caused by an overactive immune system in which the growth of skin cells occurs very quickly. Normal skin cells takes about a month to finish growing and shed from the body. Skin cells on an individual with psoriasis finish growing every few days and pile up on the surface of the skin instead of shedding off.

Psoriasis is not contagious, and is not always hereditary. In most cases, psoriasis is characterized by raised areas, or plaques, on the skin that are typically red, itchy, and can burn or sting.

It is relatively unknown as to what causes psoriasis in a certain individual, but we do know that it occurs when the immune system reacts to a triggering event, such as an illness, increased stress, exposure to hot or cold temperatures, contact with an allergen, or even trauma to the skin, such as a burn, scrape, or a vaccination.

Psoriasis Symptoms: Types, Locations, and Characteristics

Individuals who suffer from psoriasis describe it as a persistent burning, stinging itch, unlike a typical rash or irritation from an allergen or dry skin.

There are actually five primary types of psoriasis, each with unique characteristics and varying levels of severity. These types of psoriasis can all affect different parts of the body, and some individuals have more than one type of psoriasis. 

Plaque Psoriasis: This most common type affects 80-90 percent of individuals diagnosed with psoriasis. Plaque psoriasis manifests as raised patches of skin called plaques, which are itchy, red, inflamed, and often appear to have silvery scales or even a dark coloration, depending on skin type.

Inverse Psoriasis: Affecting about 25% of those living with psoriasis, inverse psoriasis is most commonly identified by the lack of scales on the skin that are so common with plaque psoriasis. It is also most often found within skin folds – under arms, under the breasts, or in the genital or buttocks areas.

Guttate Psoriasis: Slightly different in appearance from other types of psoriasis, guttate psoriasis typically manifests as small red spots, and is frequently found on the arms, legs, chest, stomach, or back. Guttate psoriasis is less common, affecting about 8 percent of those living with psoriasis.

Pustular Psoriasis: A far smaller population of people (about 3 percent) are affected by this type of psoriasis, which is characterized by pus-filled bumps that are painful and irritated. While it is most commonly found on the hands and feet, it can also appear on any area of the body.

Erythrodermic Psoriasis: Very rarely, individuals with psoriasis may develop erythrodermic psoriasis, which causes redness and excessive shedding of skin layers. About 2 percent of people with psoriasis suffer from erythrodermic psoriasis, and it can be severe enough to be life threatening. Symptoms include itching and pain, an almost burned appearance of the skin, as well as more serious conditions such as changes in heart rate or dehydration.

In some cases, psoriasis can lead to other health conditions, including psoriatic arthritis, which can cause symptoms of arthritis in the joints, and affects about 30 percent of individuals with psoriasis. Psoriasis can also affect fingernails and toenails, causing pain, pitting of the nail, separation of the nail from the nail bed, or coloration changes.

While these types of psoriasis vary widely in how they affect people, and can be more mild or more severe depending on the flare-up and other physical or environmental factors, you should always contact your healthcare provider or dermatologist to ensure a proper diagnosis and treatment.

What’s the Difference Between Eczema and Psoriasis?

Eczema is a very common skin condition that, like psoriasis, causes red, itchy, and sometimes flaky or scaly patches on the skin. While individuals with psoriasis report more burning and stinging associated with their flare-ups, eczema can look and feel very similar, even causing bleeding at the site from excessive scratching.

Your dermatologist ultimately needs to make the final call, but there are a few characteristics that differentiate eczema from psoriasis:

  • Skin affected by psoriasis tends to be more inflamed, with raised areas that may appear swollen.
  • Psoriasis typically burns or stings.
  • Strictly in terms of the most commonly observed cases of each skin condition, eczema typically affects parts of the body that bend, like behind your knee, as well as on the neck, wrists, and ankles. Psoriasis is common in skin folds, and on the elbows, knees, scalp and parts of the face, hands, feet, lower back, and fingernails or toenails. However, each skin condition can affect any part of the body depending on the type and individual.

There are almost more similarities than differences between eczema and psoriasis, which underscores the need to consult your doctor for an accurate diagnosis.

Managing Psoriasis Symptoms With the Right Treatment Plan

Psoriasis currently has no cure, and because it’s a chronic disease, those who have it will have it for life. While psoriasis can occur at any age, it first appears most commonly in individuals between the ages of 15 and 35.

The symptoms of psoriasis do come and go, and the onset of symptoms, or flare-ups, can vary in severity. The goals of psoriasis treatment are to reduce the occurrence of flare-ups, and to reduce the severity of those flare-ups when they happen.

There are a few different ways to manage psoriasis. Patients may try multiple approaches before finding one or more that make a difference.

  • Corticosteroids and other topical treatments: Corticosteroid creams, ointments, or sprays can relieve the discomfort of a psoriasis flare-up by reducing inflammation and soothing irritation.These treatments are typically prescribed by your primary care doctor or your dermatologist.There are also many other topical treatments available, including coal tar, Vitamin D analogues, or salicylic acid.
  • Diet: While there is currently no evidence pointing to diet as a trigger for psoriasis,    many psoriasis patients notice a correlation between certain foods they eat and their flare-ups. Because psoriasis is an inflammatory disease, foods that reduce inflammation, such as those high in Omega-3 fatty acids, are thought to be helpful.
  • Weight: Obesity has been shown to correlate with psoriasis, and can make psoriasis more difficult to treat. Weight management has far-reaching benefits for individuals struggling with any autoimmune disease, and for psoriasis patients, it can help mitigate those triggers that may bring on flare-ups, such as high blood pressure, high cholesterol, or other metabolic conditions.
  • Meditation, Exercise, and Lifestyle Improvements: Because stress is thought to be a trigger for psoriasis, patients who focus on stress relieving activities like meditation or exercise, or make lifestyle changes to reduce day-to-day stressors, may see improvements to their flare-ups.
  • Light Therapy: In some cases, your dermatologist may prescribe ultraviolet light therapy. With this treatment, UVB rays applied over a consistent period of time penetrate the skin and can slow the growth of affected skin cells.

Within the last few years, different prescription drug treatments, or biologics, have come onto the market to help people manage their psoriasis, and have been found to be highly effective in treating psoriasis symptoms. However, individuals should consult with their doctor prior to taking a biologic, as these drugs can suppress the immune system in ways that can lead to serious infections, such as tuberculosis.

There are other medications available that can be used in place of biologics. Both biologics and other medications can be administered orally in liquid or pill form, or through an injection or intravenous infusion.

Treatment depends on the type and severity of your psoriasis, as well as other health conditions or concerns you may have. Speak with your dermatologist about the right medication or other treatment for your psoriasis.

Creating Greater Awareness Around Psoriasis

Finding a treatment is important for reducing the discomfort that can come with psoriasis flare-ups, but for many individuals suffering from psoriasis, there is an emotional impact as well. Even mild psoriasis can make individuals feel self-conscious or lead to social and mental health consequences. With stress being considered a trigger for psoriasis, it can create a challenging cycle for individuals feeling anxious about the appearance of their psoriasis when in public settings.

Fortunately, awareness about psoriasis has grown exponentially. The month of August is National Psoriasis Month, helping to spread information about this disease and make those who suffer from it feel less isolated. Coupled with television commercials for psoriasis drug treatments and billboards and other advertising highlighting the challenges of psoriasis, there is far more acceptance and hope for people with psoriasis than ever before.

At the Dermatology Center of Indiana, we help our patients find the right treatment for their psoriasis symptoms. We work with you to understand and manage your psoriasis so you can get back to enjoying your life.

Visit our website to find a Dermatology Center of Indiana location nearest to you, and request an appointment for a diagnosis and to begin conquering your psoriasis.